Sudden Cardiac Arrest: Higher in Blacks?

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(The Root) — Kimberli Taylor-Clarke and her husband, Khary, were a love match. They were college sweethearts, still together after 11 years and happily raising their first child. Khary adored his family, but he also let Kimberli know that at least four nights a week, he had an appointment.


"That was his way," Taylor-Clarke recalls, "of letting me know he was going to find a basketball game somewhere for his evening workout." So, on a hot July night, when the young couple were still unpacking boxes at their new Nashville home, Khary took a break and announced that he was off to shoot some hoops with friends.

"He was gone about two hours, when my phone rang," says Taylor-Clarke, her voice catching in her throat. "It's still tough to talk about, even though it's been four years. When Khary's friend called and told me he had passed out on the basketball court, I was so sure that nothing was wrong, I just said, 'Well, did he get up yet?' When he replied that Khary was still on the floor, as a physician, I suddenly knew that something was terribly wrong."

About 20 minutes later, Khary Clarke, 33, passed away at a nearby hospital from sudden cardiac arrest. Kimberli Taylor-Clarke, a cardiologist, was shocked because she could not understand how her husband, whom she described as "an incredibly fit health nut, who was raised a vegetarian, played ball and worked out several days a week," could have died from a heart problem.

Hidden Risks

SCA is a shockingly common form of heart failure that takes a life every 90 seconds. Yet while SCA is unpredictable, it may be preventable in more than 75 percent of cases, if you are aware of your risks. The problem is, says Walter Clair, M.D., a cardiologist at Vanderbilt Heart and Vascular Institute in Nashville, "most Americans and an even larger number of African Americans are unaware of their SCA risk."

In Khary Clarke's case, the clues that might have saved him were hidden in his family's history. "Afterward, I discovered there were many men in Khary's family who had died suddenly from heart disease," Taylor-Clarke says. "An examination also revealed that Khary had a valvular problem in his heart that had never been diagnosed." Khary's regular physicals, even during his years playing professional ball, were not comprehensive enough to reveal a ventricular disorder in his heart. As surprising as Clarke's story may seem, it is actually far too common.

Who Gets SCA

In a survey released on Oct. 17, the Heart Rhythm Society, along with Ipsos Healthcare, reported that SCA claims 350,000 lives in the United States each year, at a rate of nearly 1,000 people per day. Despite the fact that SCA is a leading cause of death in the United States, only 18 percent of African Americans were aware of the condition, compared with 24 percent of the larger population. Physicians also demonstrated a startling lack of knowledge about SCA, with 90 percent of African Americans saying their doctors had never talked to them about their possible SCA risk.


Because of a cascade of risk factors — higher rates (pdf) of cardiovascular disease, hypertension, obesity and other health problems — African Americans also have a higher risk of SCA. "African Americans' increased chances of losing their lives to SCA may also be attributed to a lack of access to proper care," Clair adds. The Heart Rhythm Society-Ipsos survey illustrates his point. The survey found that even when African Americans were diagnosed with a problem that might lead to SCA, they were less likely to be given the optimum preventive treatment: an implanted defibrillator (a device to regulate the heart's rhythm) or appropriate medications.

Many African Americans may also be less concerned about their risk of SCA because they think it's the same as a heart attack, but that's not the case. Understanding how SCA is different can help save lives. "Think of it this way," Clair says. "A heart attack is essentially a plumbing problem. It occurs because one or more of the blood vessels that bring blood to the heart are clogged. During a heart attack, the heart may continue beating." A heart attack may also be mild, moderate or severe, and many people survive. 


"Sudden cardiac arrest is an electrical problem that interrupts the rhythm of the heart," Clair explains. "When it occurs, the heart stops beating and stops pumping blood to the rest of the body. Think of it as the electricity being turned off in the body." And only about 5 percent of SCA victims survive.

Every Minute Counts

"With sudden cardiac arrest, receiving proper treatment within four to six minutes is critical,"  Clair warns. "Starting cardiopulmonary resuscitation or defibrillation immediately can restore the heart's proper rhythm. Hospital care is still necessary because the effect may only be temporary — but it may be enough to save a life."


"The other players with my husband that night were so shocked that they did not know what to do," Taylor-Clarke recalls. "But every minute that you delay, the person who has experienced SCA is losing valuable time." Advocating for placing portable defibrillators around your community ("They can be operated by a fourth-grader," Clair says) or learning and encouraging others to learn CPR is also a great help.

"Possible warning signs of SCA include fainting, feeling light-headed or experiencing lapses in memory," Clair says. "Unlike a person who has had a heart attack, a person who has experienced SCA will probably not be breathing at all. They may also have a faint to nonexistent pulse."


Advocacy and Education Reduce Risk

As frightening as SCA may be, Clair explains, "our goal is to arm people, not alarm people. This study shows us that teaching people about SCA, how to ask for proper medical tests and  practice prevention can lower rates."


Research conducted by SUNY Downstate cardiologist Judith Mitchell did find that when African Americans with heart abnormalities received defibrillators, their SCA survival rates were similar to those of other groups. In other words, survival of SCA is not dependent on race; it's dependent on getting the proper treatment.

"Having information about family risk is also important," advises Shaun Robinson, a correspondent for Access Hollywood and spokesperson for the Heart Rhythm Society and Association of Black Cardiologists' Arrest the Risk campaign to help prevent SCA. "I'm speaking out because I've lost so many people in my own family to heart disease. I want to encourage people to take charge of their risks."


"Historic issues causing distrust may keep African Americans out of the health care system, but this is one case where we really must break down that barrier," Taylor-Clarke says. "This is an epidemic, and we have to work together in our community to bring it to an end."

Sheree Crute is a journalist who specializes in health and medicine.